Diffusion tensor imaging use in concussion diagnosis of young athletes
Porter, Caroline Grace
MetadataShow full item record
Concussions in young athletes have become a critical public health concern36, with over 1 million pediatric sports-related concussions reported annually32. Despite the high prevalence of concussions, especially in contact sports, conclusive quantitative measurements of the damage associated with concussions is lacking. Most of these mild traumatic brain injuries (mTBIs) occur without macroscopic damage and have therefore been difficult to quantify with traditional imaging techniques such as conventional magnetic resonance imaging (MRI) and computed tomography (CT)22,32,46. Current concussion diagnosis criteria relies upon subjective reporting, which has shown to be inconsistent and underreported22,33. The absence of a sensitive, reliable, and conclusive diagnostic measure for concussions is dangerous, causing mild concussions to frequently go undiagnosed7,20,22. This is particularly unsafe for young athletes in contact-associated sports, who, due to age-related biomechanical differences, are at an increased risk of concussive events and lasting impairments16,29,33,36. Diffusion tensor imaging (DTI) has risen to the forefront of noninvasive concussion imaging research, as it is capable of indirectly measuring the integrity of the axons within the brain on a microstructural level15,20,22,38. Specifically, DTI measures the direction of water molecule diffusion and is able to detect even subtle changes in the brain tissue structure that may occur with axonal injury as a result of a concussion15,20,38. Previous studies have demonstrated the ability of DTI methods to measure significant differences in diffusivity between concussed individuals and uninjured controls6–8,17,20,26,29,30,32,34,39,44–46. Additionally, DTI is sensitive to normal neurodevelopmental changes that occur, making it especially applicable to the pediatric population20,46. It has shown to be capable of distinguishing between severities of concussions6,8,28 and predicting general functional outcomes8,22,26,33,46. While currently confined to use in research, DTI technology shows great promise in one day becoming a routine clinical imaging tool for use in concussion diagnosis2,22,23,38,45,46.